How to Grow Your Practice – Cash or Insurance Learn What Works – Sam Collins the Acupuncture Billing Expert

Disclaimer- This is a live transcription that has not been edited for grammar or spelling. While we do our best to assure accuracy it is recommended to view with the accompanying video.                                 

Hi everyone. This is Sam Collins, your coding and billing expert for acupuncture, not only the acupuncture profession, but of course the American Acupuncture Council and the Network as well. Welcome you to another edition. And today we’re going to discuss. How do you grow a practice? What are we doing? And what’s going on out there.

And I get this question quite a bit from teaching so many seminars over the years in dealing with so many acupuncturists, one of the common questions are, how do I grow? What do I do to get better? What do I do to get more people? And so I want to address that really from both ends of the patients, you’ll get, whether it’s going to be a cash practice and insurance practice.

Com combination of both. It’s going to be a matter of how do you attract the patients that you’re looking for. And let’s give you some ideas and some things to chew on and think about to see how your practice is going to change. Because one thing I will say is you always have to be willing to admit.

And to make changes. If you think of it, when you first started practice, you probably don’t treat this the same way you did when you first left school or five years ago or 10 years ago, if it’s been a long time and that’s because you learn and grow, it’s one of the reasons we have continued education.

And in fact, I would say, it’s why we call it a practice. And not a perfect, so let’s go to the slides. Let’s talk about what we want to do to grow our practice if you will. So here you go. We just look at how we change from that little bud to something that moves a little bit more. Let’s talk first on what do we consider success?

And this is something I think sometimes is going to be defined differently by different people. And where I have a concern is often too many people try to define what someone else should do, as opposed to just define on your own. So I would say define your own practice success for some of you. It could be, I need to make a million dollars for others.

I just want to help patients. And obviously I think everyone wants to do a little bit of both. I’m not sure I want a million dollar practice. That’s probably a million headaches, but think of how are you going to define what you’re doing? What does a successful. I would say it’s a combination of certainly there has to be a monetary success.

You have to stay open, but at the same token, the satisfaction, this is the part that I’m not sure patients always know what we do or how we do it and the results of care. And I want you to think of it in these terms. How often has you have someone that’s coming to your office? Not feeling good and literally left feeling better.

When does that ever happen? Outside of an acupuncture practice, frankly. Has anyone ever went to a medical doctor with a headache and left with it better? And I’m not saying that as a negative towards the medicine, but that’s not how they treat. So I want to think of what we have to define it, but then if we’re defining it, what are the barriers?

What are the things preventing us from really moving forward and doing a little bit more? How are we getting more people are not getting more people, where’s it going to come from? What things are we looking for? Is it a matter of changing styles and techniques to get better results? So start thinking of what are some of the barriers I’ve set up internally, meaning among yourself, but also among the patients.

I think for patients, you always have to think of how they value our service. And I think this is going to be the number one way to think of it is that people value a service. And when they value. They’ll get it. They’ll pay for it. If they don’t value it, they won’t. So we’ve got to set up that value and think of what is that barrier will barrier as often.

So we have to think of if I’m going to grow a practice and money’s the barrier, how do I change that? How do I make it work? So think along the lines of what is the model I have, like currently, what is your model? Have you really set forward a business plan. It’s something that you set for and say, here’s what I want to do this year.

And literally write down some ideas because until you write it down and then really follow through, it’s going to be too esoteric. So I think it starts with people in. So you’ve got to think of first off the barrier is people just knowing what we do, why we do. So I want to ask you, what does acupuncture do once you think of what you think it does, but I also want to think along the lines of what does the average person understand about acupuncture?

What is defined what’s out in the field that lets them know what we do, what message have we gotten and what message has the profession or others set up for us? I know a lot of what we have to deal with this kind of. Healthcare in the U S is very medical oriented, obviously. And it seems that people like to line up for pills and surgery, but when it comes to making changes in their life, having a better lifestyle to stay healthy, they want to be lied to, it’s okay. In other words, it’s interesting when people think of insurance, we often use the term health insurance, but I would ask you, is it really, is it actually health insurance, or is it sick? In other words, we have a model that we say health care, but is it really, I get there’s some preventative things.

We do cancer screenings and so on, but really is there anything to set up a person to be healthy? So that’s one way to think of there’s a portion of people that are understanding that no, I need to stay healthy and not get sick. So what role are we there and how do people know that they can even access with access that with us?

But I want you to think along these lines here, there’s an interesting meme. Someone had sent to me and I think it fits. How do you think people view acupuncture? Here’s one where it shows what your friends think. Think of, particularly for many of you who went later in life to become an acupuncturist, some of your friends are like, what.

And then of course your mom thinks you’re driving a big needle into someone. Of course that’s not the case. And then let’s face it. This Western medicine have a downside to acupuncture, to an extent. Yes, I will certainly say that’s not as bad as it was, but I’m not going to say there are proponent per se there, we’re not throwing money down the toilet, but that’s often what they’ll say.

What we think we’re doing is so much bigger than that, but let’s take it. There were two realities. What people still do take medications. Don’t do well. Face it, the VA has a problem with suicides and deaths because of the way that. But what do we really do think of this? A patient often feels when they come for acupuncture, but do people know that?

So what is our message? What information is out there? We’re, here’s two examples. The Mayo clinic and Cleveland clinic, this is something they have on their website about what acupuncture does. And though there’s some similarities there’s differences between the two, which you can see here, chemotherapy induced, nausea, dental, pain, fibromyalgia headaches, labor pain, low back pain, neck pain, osteoarthritis.

And so on, on that side. But notice here it says differently. And stroke cramps, sports injuries, cancer, and cancer treatment for side effects, face pain. I think of Justin Bieber recently had that issue. I hope he’s going to an acupuncturist, immune problems, infertility irritable bowel. So this is a pretty broad scope of things that acupuncture does, but yet, how does the average person know this?

Now? I just searched this at their website. So if you think of it, when someone’s searching for what acupuncture. This is going to be the first things that popped up. And I did that because I wanted to see what does come up. So we want to start to think of, if people are seeing this, how are we communicating the message or do we want to communicate a different message?

Here’s something interesting from the company, Kaiser Permanente, a big health insurer and the doctor all in one, it’s an HMO and this is from their head acupuncturist at the Kaiser. And it says, what does acupuncture treatment says in China? Acupuncture is used to treat. It’s not thought of as alternative medicine, which is very true for most people.

It’s a common part of their medical care in China. Acupuncture is often used as complimentary treatment for all types of health conditions. And that’s one of the things that through my work with Maryland and Ellen and others at WHS. The world is beginning to recognize that acupuncture is way more than just pain relief.

We know that acupuncture speeds recovery. I would suggest every person w having any care post-surgery should have acupuncture. However, again, are people aware of it and have they had a chance to try it. And I think this is going to be our issue. So when we talk about growing your practice, we have to attract people that know that what we can do can help.

By example, we leave it up to the other companies. I just showed you what comes up on the Mayo clinic. So if you typed in, what does acupuncture do? The number one is going to come from those areas, but you’ll notice this here companies like United health care use acupuncture as a medic. To advertise people to buy their product.

So do you think that they’re using acupuncture as a tool for people they are, which means there’s access? What if someone says what do you mean? I get acupuncture visits with zero copay. I think I want to go in now realize that this is a plan that I’m not going to say it pays a lot of money, but it pays it above a hundred dollars a visit.

So certainly something that might be viable for some, for others, they may say, Nope, I want to do all cash. What my point is. If a patient comes in with this and you are not available to it, they going to go and, or can you sell them an alternative? Look at this particular company for a Medicare advantage plan, literally they’re talking about acupuncture, but showing it.

So I’m seeing a lot more people now becoming a little bit more attuned to say, Hey, maybe I want to try it because we’re seeing it out there more. I want to start to change the narrative and attract people to what I do by example, here’s the company Evercore. Now, sir. 20 years ago, would insurance coverage was different, but Evercore, which manages a lot of plans, you’ll notice here, the things that talks about adjunct cancer care and mental health.

Now mental health is more than PTSD and anxiety, but even anorexia bulemia. Let’s face it a little bit of everything, including menopause. So we’ve got to start to realize that there’s a message out there. Are we directing that message? What is our message? What is your message? If you’re growing your practice, if someone’s going to find you, how are they finding.

Why are they going to come to you? What is the messages like if someone were to look you up on your website or your blog page or anything like that, what would they know? What if they drove by your office? Would they know anything about what you do and the why I should come? And I will tell you, we’ve got to set up that people have to have not so much a need, and I’m not saying there isn’t a need, but a want, and this is something that my mom taught me early on.

She said, people will buy what they want. And big for what they need. And this is part of the reason I think acupuncturists can do very well with cash. Partly because insurance is traditionally not covered as well. So therefore we’ve not relied on it. In fact, the American physical therapy association noted that if patients have a $30 copay, they won’t go into Acupac or go to a PT, or at least a third of them, they don’t find that same thing for Acura.

And I think because we set that message of someone wants the care. It doesn’t just feel like I need it. And we’ve not realized. So in other words, we have to set up and create a value. So if you’re going to grow, you have to grow by expanding some way either you are going to see more people or less people, more visits one way or the other, which means there’s some out of value set up.

So you’re going to think of, as someone drove by your office, What would be the message. Here’s a couple of examples of offices that put up things like, what did they treat? Think of how often someone might have something like fibromyalgia and they’ve never heard that acupuncture can help it. So why would they think you can help it?

What about Bell’s palsy or weight control? We have to set the narrative because think of when someone passes by, they see acupuncture, I don’t even think about it. I’m going to suggest we want to start creating that. Outside your office. What do you do? Do you do fertility? If so, let people know because why would someone come to you if you don’t, they don’t know what you do because you don’t tell them.

In addition to that, I want to think of, what about does your website say about you? Here’s an interesting, I just did a quick search to. Acupuncture and insurance coverage and acupuncture treatment. And this is one of the things that popped up. And I thought this was interesting. What types of health insurance covered?

I, this is actually someone’s website. I didn’t put their information at the top, but notice they’re indicating if someone says, Hey, I have this particular plan. I know what it can do. Aetna banner blue, cross blue shield plans that they take, if you’re going to, except some, I would certainly let people know.

Cause if someone has, But you don’t list it. Why would they come in now? Good news. Do you have to accept insurance? No. In fact, even have to bill insurance. No, that’s a courtesy. My suggestion is always to have a diversified practice. And what I mean by that is diversified in this way. I’m going to take people who can pay for my service, what I prefer, all cash.

You bet I would. But what about the people who have insurance? Would I turn them away now? Certainly if I have a plan that doesn’t pay very well, not too many. But plans that do, I certainly would want to be part of that or at least accept them. Keep in mind if there’s an insurance, you don’t want to build don’t bill.

When you do want to build, you would, but if you’re accepting any, does anyone know? Think of it. What if someone says, Hey, I have Aetna and they were looking for a provider. Would your name pop up? Remember if you don’t have a search engine that does it, it’s going to be a problem. Here’s one that as another website that I did, and those are the things that.

Bell’s palsy, difficult diseases, natural pregnancies, skin conditions, pediatric and geriatric care, migraine headaches, severe and chronic pain. What are they sending that message towards? Who are they trying to attract? Why are people will come into that office? What about veterans? If any of your treating the VA I would ask you, does anyone know that you treat it and in other words, think about it.

When someone sees you, what do they know about. The message we get and sometimes that message we’re letting someone else determine it. So I want you to think of a model situation. You are a business. So think of the show shark tank a little bit. If you were to take your business model onto the show shark tank with someone invest.

Now, I’m not saying in reality, but the idea is that a solid business model. So you’ve got to think of businesses. How do businesses change and grow or close by example, the company series. Was the biggest retailer in fact, had a complete catalog and shipped everything. What did Sears not do? They didn’t adapt.

I think of it. Amazon took their idea. What if someone at serious said, Hey, wait a minute. This company is, we’re going to go back to that. We already have a catalog. Why didn’t they do that? Because I felt there were too big. And so they wouldn’t integrate, they wouldn’t adapt. So what happened to Sears? But it’s interesting when you take other stores, take the store target.

I find that interesting from a business standpoint, if you go into target, you’ll notice when you first walk in there’s a little 99 cents store items in that place. They, they got three, four hours, not a lot, but what is that doing? It’s attracting the nine instance. ’cause people like that stuff.

Why not offer a little bit of it? So think of in your practice, do you offer a diversified way for people to come in there? Is it one way or the highway? I’ll give an example. I have a very good health insurance. I literally have no deductible. I pretty much have no copays. That sounds crazy, but let me have you understand something for that plan.

It costs me and again, you’re going to think. I’m kidding. Okay. About $3,000 a month just under that. So when I say I have no doubt. What does that really mean? Yeah, I don’t, but I’m paying $36,000 for no deductible. So the reality is it’s expensive. So does everyone have that type of policy? No. So if I walked in, I would certainly say, you’d go, yeah, I’m going to take your policy because it’s a really good one, but not everyone’s is, and that’s something you have to learn that there’s nothing wrong with cherry picking.

You can say, oh, I’ll accept this plan, but won’t accept that one. We do the same with any patient. So think about what is your diversification here? Have you seen modern acupuncture? That’s very. That’s an all cash. How do they make that work? Part of how they do it is they make their visits very inexpensive.

So you have to learn how to make volume work. Now, the difficulty is that we can’t have multiple fees for the same service. Now, if you were in a completely cash practice, you can set your fees anywhere you want. But as soon as you bill insurance, now we have to have a balance because you can’t appreciate the ability to insurance patient more than a cash patient, makes sense.

Same price. Now, keep in mind though, this model does work well. It’s a very popular one. Now, how does it work though? People don’t buy a single visit? You can, but it costs a hundred dollars. If you buy packages of visits, it changes to as little as 60 or maybe 40 or even $20 a visit. It’s just a matter of making sure we have done it right now.

I’m going to say to you, is there any reason you couldn’t offer that in your office? In other words, you’re like targeting you offer that cause are there going to be patients interested in it? I have a couple of practices that their whole practice is based on prepaid. Liberal. The in fact, they don’t do anything but prepays.

And she says that they sell about 25 to 30 every month. Her cheapest one is about 600, most expensive, about 5,000. No kidding. Now she will tell you she doesn’t sell that many of the 5,000, maybe one or two a month. Still not bad. The idea being though she set that up. Now the difficulty with that though, was this, when you have that type of practice, if the economy.

Is low. Does that start to dry up? So I’m going to suggest yes, but why do it? And I offer both, in other words, I will take some good insurance, but I’m not taking all of it. And I would prefer to do more cash, get people interested in health care. Remember insurance only covers so much. What about your true health care?

So you want to think along the lines of what about doing that, but here’s the part I want you to see? What does someone see? How is your office viewed? What do they know that you do? What do they know that your costs. How do you come across on a personal level? When people see you, do they see someone professional?

Do they see someone when they meet oh, this is the person I want to go to. This is a person that gave me some writing formation. What is the community around you think? How are you in the city or the community you’re in? How are you viewed? We set that narrative. What is your web presence? What if someone were to search acupuncture to treat whatever and your city, would your name pop up?

Here’s something I’ll guarantee you the American acupuncture council, the network, our education division. If you were to type in acupuncture seminars, guess who’s going to pop up first. We do. We do it by design. It’s not by happenstance. We make sure we put out a lot of information too, about how to run your practice.

And it’s not about all insurance. But that way, people know that you need continuing education in heck we teach a heck of a seminar that deals with just cash. But again, will you show up? What if someone says, man, I have migraines. Have you ever written anything up about it? Is there any information they might find?

Is there any blogs or any written video? Because you remember for a search engine is going to look for people who have put. If you’ve not put any information, you’re not going to come up. So start to think of where do we show up? Remember the old days of a yellow pages. No one does that anymore. So how did they find you?

What are we creating for referrals within our own patients? Is there any newsletters you send? Let’s go old school, send them out via email or even mailing. What do people know? I have an office that what they do is they work with. And every time they sold one of those welcome packets they’re included in there.

Cause I know I get some periodically in my neighborhood and it’s always a dentist or two chiropractor, a few medical doctors, but have you ever thought, Ooh, is that a way for you to go in? Hey, I’m looking for an acupuncturist and then think about what about groups that you might work with? Have you ever thought of any civic groups that might need someone to come do a lecture now?

I’m not saying that’s going to be as prominent now that’s probably coming back, but start to think of how am I adding. Have I worked with any sports teams and I’m talking not professional, but what about being the person for a high school team that helps deal with pain? I’ll give an example. The I coach high school kids.

And one of the things they know is if coach Collins is talking to him about treatment, I’m always wanting them to get acupuncture because I have found a person with acupuncture gets well faster, simple as that. And once they see it work, it becomes a thing. And quite frankly, I coach at the most prominent sports high school in the U S and everyone knows what’s going to happen when you’re one of my athletes.

My goal though is that, do people know that you do that? So where are your patients? There’s lots of patients. Everybody’s account. Technically even some insurance. So start to think of how am I getting my cash? Am I advertising? If you are all cash, how are you using that to your advantage? Is it on your site that your price is cheaper, it’s more affordable or is that the right?

We don’t want to go. We want to talk about the quality of care. Here’s one thing I’m always concerned with is cheaper. Always better. I don’t think so. I’ve never picked a doctor because it’s cheap. No. Now, I’m not saying there isn’t times that many of us do, but I want to think along those lines, but realize there are things you can do.

What about a prompt payment? What about a pre-pay and then of course all the different types of insurance. Now, what you’ll see here as well, there’s nine different ways of insurance. I will point out not all of these are good. And I think this is where people go wrong. You are going to have a practice that’s diverse and accept the things that are welcome to you.

And the ones that aren’t the medical doctor I go to, which is very rare. He doesn’t take PPO and HMO insurance. If you don’t have a plan like I do, he doesn’t accept you. You can pay. But if you’re going to use insurance, he doesn’t accept those lesser ones. Now his practice is busy cause he’s built that you’ve got to be able to stick with it.

Know what you’re looking for? What are the patients looking for? Cause here’s what it comes down to. If your practice is going to grow it’s about patients, it’s about how do we attract them? Start to think of what have I done to attract patients and then start tracking, do things and see, Hey, did that work?

Did it help? Did you create something where you tried to create a referral based within your own. Maybe something you let them know, Hey, have your patients come in or have your friend come in, we’ll give them a free consult. Things of that nature. Does it work? Does it not work? If you do a cash discount, you do a group on, does it work?

Here’s what I’ll say, deliver what you do best, which is to make people feel better and your good care. But we’ve got to make sure people will know that we do that. And are we setting that narrative? If you’re not looking to grow. And even grow a little, you’re going to shrink, which means you won’t be around.

Here’s one of my concerns and this sounds awful, but it’s true. Approximately half of the people who graduated from acupuncture school within five years, no longer practice. And I think that’s mostly from bad management of the business. And I think partly because this is something that’s the hard thing to deal with it and know it doesn’t work.

You can make anything work. If you stick with it, there are practices that do all cash and do very well. I’ll tell you what though, by a tee, they all have really good communication skills. They also generally are in higher than average areas of income and have built that in. But if your practice is about in that type of area, maybe a bit difficult, maybe you want to be a little bit diversified.

I said, deliver what you do best. This is what I want people to feel when they go to an acupuncturist, how do they feel after? And sometimes that’s going to be your best way. Do you have anything on your site that gives patient testimonials about, I can’t believe it. That’s usually going to be the best way to commute.

I help a lot of people, everyday acupuncture offices deal with problems from billing and coding, to collecting, dealing with cash and all those things. And some of the best ways I can communicate is just simply give examples of offices I’ve helped and how we’ve helped them. And that’s how you continue for the rest.

So I’m going to say, go out and start to think if you’re not thinking of growth, if you’re not implementing it. And there’s several ways to go. There’s not only one. We’re here to help you. The American acupuncture council is always going to be your resource. We have a network service where I become part of your office.

Call me, email me. We deal with everything on a day-to-day basis, no limits. And it’s not about insurance. It’s about everything can include insurance. We are a resource go to our. Take a look, we have a lot of free things out there along obviously with these types of programs. But what I will say to all of you is think in your own practice, what am I doing to make my practice better, to make my self better?

I think we’re always doing that, but how do we communicate it? So I’m going to say thanks for the time everyone in next week is going to be Chen Yen. So again, go out, be successful. Hope to see you at a future seminar. Take care, everybody.